Introduction:
As a pelvic health physiotherapist and a mother, I know firsthand how crucial pelvic health is for women. Our pelvic floor supports us through every stage of life—from menstruation and pregnancy and birth to postpartum recovery, menopause and beyond. Yet, it's a topic often overlooked, even though it has a significant impact on our overall well-being. In this post, I’ll walk you through why pelvic health matters and how you can care for it at every stage of your journey.

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What Is Pelvic Health?
When we think about pelvic health, many of us immediately picture Kegel exercises. While Kegels are part of the equation, the pelvic floor is much more complex. It consists of a group of muscles that work together to support our pelvic organs, such as the bladder, uterus, and bowel. The pelvic floor also helps with bladder and bowel control, sexual function, and core stability.

There are two main subgroups of pelvic floor muscles (across 3 layers): the superficial layer, which controls the openings of the urethra, vagina, and rectum, and the deeper layer, known as the levator ani. This deeper layer is responsible for holding our pelvic organs in place, especially during times of stress, such as pregnancy and childbirth.

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Pelvic Health During Pregnancy and Postpartum
Pregnancy and childbirth are incredible experiences, but they can also take a toll on the pelvic floor. The weight of the baby, hormonal changes, and the process of labour can all weaken these muscles. Many women experience incontinence or pelvic organ prolapse after giving birth vaginally; a caesarean section birth lowers the risk of pelvic floor trauma, but does come with its own set of recovery challenges.

During this time, it's important to focus on pelvic floor rehabilitation. Physiotherapy plays a vital role here. In my practice, I’ve seen how a tailored exercise plan can help new mothers regain pelvic floor strength and function. For pelvic floor and core recovery to be effective, an exercise program should include addressing breathing technique, posture, spinal, hip and ankle mobility, as well as general strengthening. 

My biggest message for women during and after pregnancy is to be proactive - start your education, rehab and birth preparation during pregnancy, continue to maintain an active lifestyle, and your postpartum recovery is likely to be much smoother.   Pelvic floor issues are common (50% of women!!)  but they’re not something you have to live with. With the right support, you can regain control and confidence.

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Menopause and the Impact on Pelvic Health
As women age and enter menopause, the change in hormone levels affects our connective tissue. Oestrogen is a hormone that helps keep our pelvic tissues strong and elastic. When levels decline, these tissues become more vulnerable, leading to issues like urinary incontinence and pelvic organ prolapse.

For women going through menopause, regular pelvic floor exercises are crucial. There may be a role for other support such as pessaries, manual therapy, general exercise programs, and in some cases a doctor may prescribe local oestrogen cream. 

Pelvic health isn’t just about strength - it’s about range of motion and being ‘fit for purpose.’ Many women experience pelvic pain due to overactive or tight pelvic floor muscles. In these cases, learning to relax and release these muscles can make a huge difference.

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Incontinence and Pelvic Pain
One of the most common and frustrating pelvic floor issues is stress incontinence. It affects women of all ages and can be triggered by pregnancy, childbirth, menopause, obesity or even high-impact exercise. Incontinence can feel embarrassing, but I want to reassure you that it’s common and in the large majority of cases very treatable.

Incontinence can occur for many reasons, but if you are leaking when you cough, sneeze, jump or run, your pelvic floor may either be too weak to properly control the bladder or too “high tone”  think “always on” - meaning it may not then be able to work well to control continence due to fatigue, tightness or poor biomechanical length. Both conditions can be improved with pelvic floor physiotherapy. By assessing your specific condition, we can develop a plan to help you regain control over your bladder.

Pelvic pain is another issue many women face, whether during menstruation, after childbirth, or as a result of chronic conditions like endometriosis. Pelvic pain can be caused by tension in the muscles or trauma to the area, amongst other causes. Physiotherapy or other pelvic health specialties, addressing bowel health, gut health, and contributing conditions to restore function and quality of life. Any persistent pain should be addressed with your health care provider. 

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The Importance of Pelvic Physiotherapy
I can’t emphasise enough the importance of seeing a pelvic health physiotherapist. Whether you’re dealing with incontinence, pelvic pain, or just want to maintain good pelvic floor health, physiotherapy can help. A pelvic health expert can assess the function of your pelvic floor, identify any weaknesses or tightness, and create a personalised plan to address your needs. If accessibility is an issue - most public hospitals have an outpatients department where you can access free or low cost care; you may be eligible for some health care practitioner support through a plan with your GP; and many private physios are offering remote/ online consultations which can address most common problems.

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Empowering Women Through Pelvic Health Education
Education is a powerful tool. When women understand how their bodies work, they can make informed decisions about their health. Pelvic health is no exception. Whether you’re pregnant, postpartum, menopausal or beyond,taking the time to learn about your pelvic health can positively change your life.

Too often, women suffer in silence with pelvic floor issues, either out of embarrassment or because they assume it’s a normal part of bearing children or ageing. But I want you to know that there is help available, and you don’t have to navigate these challenges alone. By speaking openly about pelvic health and seeking professional care, we can break down the stigma and improve the quality of life for women everywhere.

Pelvic health is a lifelong journey, and it's essential to care for it at every stage. Whether you’re in your childbearing years, going through menopause, or simply looking to maintain pelvic function, you deserve to feel confident and in control of your body.

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- Rosie Dumbrell - Pelvic Health Physio & Everform Founder

*Rosie spoke on our Women's Health MasterClass Series - watch the recording here.